Kamat - Figure 35
High-risk NMIBC after TUR
FIG. 35: High-risk NMI bladder cancer patients who have had a transurethral resection (TUR) or a re-TUR of the bladder should get BCG induction with 6 weeks of BCG.[30] If they have a tumor recurrence, then decision analysis comes into play. If they have a low-grade recurrence, as discussed earlier in this presentation, this could be considered to be a non-event and these patients can continue on BCG maintenance with surveillance. If these patients have had a high-grade recurrence, they must be evaluated with imaging or be considered for adjunctive imaging modalities such as blue-light or narrow-band imaging and cystectomy with biopsies; prostatic urethral biopsies should also be considered. The next question, of course, is whether there is a high-grade recurrence in the bladder at 3 months.
References
The Cancer Genome Atlas Research Network. Comprehensivemolecular characterization of urothelial bladder carcinoma. Nature. 2014:507:315−22 http://www.nature.com/doifinder/10.1038/nature12965
